Sunday July 25, 2010

BENNINGTON -- Dr. G. Richard Dundas, founder and medical director of the Bennington Free Clinic, said the clinic consisted of one exam room and one doctor seeing patients when it opened at the start of 2009.

The clinic was immediately filled to capacity when it was open on Thursday nights. With the opening of two more exam rooms a few months later, which allowed two doctors to see patients at the same time, the clinic was still a full house.

Dundas said he’s at the clinic on Thursdays from 6 p.m. to 10:30 or 11 p.m., though it’s not feasible to see patients any longer than that. A new Monday clinic has been added to deal with demand.

Clinic General Manager Sue Andrews said a major reason for the enduring need for the Bennington Free Clinic is that "there are very few offices that are open to new patients, even if you presented gold bullion. You can have the best insurance in the world, but they’re closed."

Currently, there is a nurse practitioner in Bennington taking new patients and two doctors in Manchester, but "all the other practices are closed to new patients. So all those people end up going over to the (hospital emergency room) to get their problems taken care of," Andrews said.

This is due in part to payment issues, practices being full and a doctor shortage.

"I think it’s a mix of all of those things," Andrews said. "I mean, the paperwork is incredible, we’ve lost some physicians over the past few years, the hospital and whoever else is responsible for recruiting new physicians has a very hard time getting new docs into our area because the payer mix, as we call it, is very very dependent on Medicaid and Medicare, neither one of which pays cost. So it’s kind of a losing situation.

"The other issue, which is a national issue, is that med school students don’t want to go into primary care, they want to go into specialities and stay in the cities, where they can make a good living," she said. "It’s a special person to come to Bennington County and enjoy fresh raspberries in lieu of a higher salary."

"I think it’s a huge issue locally, and I think it’s going to burst wide open locally when middle class people start knocking on doctors’ doors and find that they can’t get in."

Dundas said few new doctors want to be family practitioners or internists anymore because of massive amounts of paperwork that have to be done for insurance companies such as getting authorization for procedures and tests and filing appeals of denials.

"It’s just a terrible, terrible hassle," he said.

Dundas, who is semi-retired from private practice, doesn’t see lack of family practitioners as primarily a monetary problem and sees no remedy in the new federal health care reform law. For one thing, there will be just as many insurance companies to deal with as before in the new law.

He remains a supporter of a single-payer, Medicare-for-all type of system.